Osteoarthritis (OA) is one of the most prevalent musculoskeletal disorders worldwide, with the hip and knee as the most often affected sites. with an increased incidence with increasing age, this disease is very common in the older population. Exercise has been shown to have an important role in the prevention and or management of symptoms associated with OA. Until recently, most exercise programs for OA focused on land based prescriptions, however, aquatic exercise programs in the treatment of OA are beginning to gain traction with an increase in research.
Objectives
1. Benefits of aquatic therapy within this population
2. Explore evidence related to aquatic therapy in OA
3. Parameters regarding aquatic exercise prescription
4. Appropriate use of aquatic therapy
Benefits of aquatic therapy in patients with osteoarthritis
Aquatic therapy utilizes the properties of water including the beneficial affects of buoyancy. Water is an ideal medium for exercise in people with arthritis. The buoyancy properties in water allow for movement with decreased weight bearing, unloading painful joints and increasing pain free exercise capacity.
With the decreased effect of gravity and increased extensibility of the tissue due to the warming effects of water, ROM is increased, both active and passively.
Similar exercises can be implemented in both water and land-based activities with a decrease it fear of falling due to a decrease in pain.
Evidence supports use of aquatic therapy for patients with OA
Studies have shown up to an 11% increase in 6 minute walk tests after a 12 week aquatic program when compared to control groups.
Aquatic exercise studies have shown a moderate increase in functional activities post exercise when compared to land based control groups.
Strength in lower extremity muscle groups increased at a great relative rate then participants of control groups.
Studies have have shown moderate to low increases in quality of life as evidence from SF-12 form.
Aquatic exercise prescription From the literature
50 minutes aquatic exercise class targeting aerobic conditioning as well as lower extremity strengthening, 3 days a week for 12 weeks
150 minutes of exercise over 3 alternating days for 8 weeks. Each session is split into warm up, flexibility, aerobic and strength training.
60 minutes of exercise 3 days a week for 12 weeks with aerobic conditioning followed by strength training.
Average depth of submersion was 5 feet.
Water temperatures ranged from 86-93 degrees.
Further research is recommended
Using aquatic therapy treatment techniques in the rehabilitation of older patients with painful knee and lower extremity osteoarthritis requires further study and design techniques. Though there is sufficient evidence suggesting the use of aquatic therapy within this population, there are still gaps in research. The studies that are documented here, use very similar therapy techniques as those designed for land-based therapy, I would suggest future studies exploring new techniques for the treatment of osteoarthritis that are very specific to the benefits and properties that water can offer.
Meili, L. (2015, February 19). Effectiveness of aquatic exercise for treatment of knee osteoarthritis: Systematic review and met-analysis. Retrieved July 2, 2016, from file:/C:/Users/rdick_000/Desktop/wiki folder/art%3A10.1007%2Fs00393-014-1559-9.pdf
Wang, T. (n.d.). Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. Retrieved July 3, 2016, from file:/C:/Users/rdick_000/Downloads/Wang_et_al-2007-Journal_of_Advanced_Nursing.pdf
Meili, L. (2015, February 19). Effectiveness of aquatic exercise for treatment of knee osteoarthritis:
Systematic review and met-analysis. Retrieved July 2, 2016, from file:///C:/Users/rdick_000/Desktop/wiki
folder/art%3A10.1007%2Fs00393-014-1559-9.pdf
4. Kim, I. (n.d.). The effectiveness of an aquarobic exercise program for patients with osteoarthritis. Retrieved July 4, 2016, from http://ac.els-cdn.com/S0897189710000923/1-s2.0-S0897189710000923-main.pdf? _tid=e8362dc4-41fc-11e6-b894-00000aab0f6c&acdnat=1467646696_ee8d0c31a18eb6d509cf93e391319ca0
5. Escalante, Y. (n.d.). Effects of exercise on functional aerobic capacity in lower limb osteoarthritis: A systematic review. Retrieved July 4, 2016, from http://ac.els-cdn.com/S1440244010002033/1-s2.0- S1440244010002033-main.pdf?_tid=d4fd1654-41fd-11e6-bcfb- 00000aab0f01&acdnat=1467647093_b8f87058d86df1959d7559afe0047902
Osteoarthritis (OA) is one of the most prevalent musculoskeletal disorders worldwide, with the hip and knee as the most often affected sites. with an increased incidence with increasing age, this disease is very common in the older population. Exercise has been shown to have an important role in the prevention and or management of symptoms associated with OA. Until recently, most exercise programs for OA focused on land based prescriptions, however, aquatic exercise programs in the treatment of OA are beginning to gain traction with an increase in research.
Objectives
1. Benefits of aquatic therapy within this population
2. Explore evidence related to aquatic therapy in OA
3. Parameters regarding aquatic exercise prescription
4. Appropriate use of aquatic therapy
Benefits of aquatic therapy in patients with osteoarthritis
Evidence supports use of aquatic therapy for patients with OA
Aquatic exercise prescription From the literature
Further research is recommended
Using aquatic therapy treatment techniques in the rehabilitation of older patients with painful knee and lower extremity osteoarthritis requires further study and design techniques. Though there is sufficient evidence suggesting the use of aquatic therapy within this population, there are still gaps in research. The studies that are documented here, use very similar therapy techniques as those designed for land-based therapy, I would suggest future studies exploring new techniques for the treatment of osteoarthritis that are very specific to the benefits and properties that water can offer.
Additional Resources
References
- Meili, L. (2015, February 19). Effectiveness of aquatic exercise for treatment of knee osteoarthritis: Systematic review and met-analysis. Retrieved July 2, 2016, from file:/C:/Users/rdick_000/Desktop/wiki folder/art%3A10.1007%2Fs00393-014-1559-9.pdf
- Wang, T. (n.d.). Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. Retrieved July 3, 2016, from file:/C:/Users/rdick_000/Downloads/Wang_et_al-2007-Journal_of_Advanced_Nursing.pdf
- Meili, L. (2015, February 19). Effectiveness of aquatic exercise for treatment of knee osteoarthritis:
Systematic review and met-analysis. Retrieved July 2, 2016, from file:///C:/Users/rdick_000/Desktop/wikifolder/art%3A10.1007%2Fs00393-014-1559-9.pdf
4. Kim, I. (n.d.). The effectiveness of an aquarobic exercise program for patients with osteoarthritis. Retrieved July 4, 2016, from http://ac.els-cdn.com/S0897189710000923/1-s2.0-S0897189710000923-main.pdf? _tid=e8362dc4-41fc-11e6-b894-00000aab0f6c&acdnat=1467646696_ee8d0c31a18eb6d509cf93e391319ca0
5. Escalante, Y. (n.d.). Effects of exercise on functional aerobic capacity in lower limb osteoarthritis: A systematic review. Retrieved July 4, 2016, from http://ac.els-cdn.com/S1440244010002033/1-s2.0- S1440244010002033-main.pdf?_tid=d4fd1654-41fd-11e6-bcfb- 00000aab0f01&acdnat=1467647093_b8f87058d86df1959d7559afe0047902